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MMS 4001 41st Street NW Rochester, MN 559018901 Authorization to Release Information Please fill out completely. I authorize, Please PRINT Name of Individual to Receive Information Relationship of

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What is authorization to release information?

Authorization to release information is a document that allows someone to give permission for their information to be shared with a third party.

Who is required to file authorization to release information?

Anyone who wants their information to be shared with a third party is required to file an authorization to release information.

How to fill out authorization to release information?

Authorization to release information can be filled out by providing personal details and specifying the information that can be shared.

What is the purpose of authorization to release information?

The purpose of authorization to release information is to allow individuals to control who has access to their personal information.

What information must be reported on authorization to release information?

Information such as name, date of birth, contact details, and the specific information that can be shared must be reported on authorization to release information.

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